Causes of Psychological ED (Erectile Disorder)

Causes of Psychological ED

When a man has difficulty achieving or sustaining an erect penis he has ED. ED is considered psychological if there is no obvious physical reason for this difficultly. Commonly a man with psychological ED will be able to get erect in some circumstances (watching porn) and not others (with his partner). The biology which underlies psychological ED is tied to the interactions of the nervous system. Essentially, something has interrupted the action of the parasympathetic nervous system, the relaxation side of the nervous system, which is also the sexual side. Once this has been interrupted, most commonly by anxiety, then it becomes increasingly difficult to activate the sexual responses.

I’ve worked with psychological ED for most of my 18-year career as a therapist and I’ve always found it to be a highly responsive condition. In this blog I’m going to examine the underlying process which causes and maintains psychological ED, a process called traumatic learning. You may be interested in specific psychological causes, if so take a look at 7 psychological causes of ED.

Psychological ED – Traumatic learning

Traumatic learning is process whereby the guy has an upsetting experience which sets up a negative though pattern. It consists of 2 stages, the trauma and failure focused thinking.

Psychological ED – Trauma

This starts with a guy not getting an erection when he would otherwise expect to. Embarrassment and/ or confusion take hold. Sometimes they will be able to explain it away to themselves (“I’d had waaay too much to drink”) and thus often it doesn’t become a problem. However, whatever the cause, sometimes it is not so obvious. This lack of clarity can lead a guy to question themselves, “will this always be the case?”, “Will I ever get erect again?” Most men subconsciously assume that they will be able to get hard should they want to. This assumption is shattered. Embarrassment becomes shame as a fear of failing as a man comes upon them. This may be immediate or take a few days. The result of which is they become apprehensive of sexual situations and enter a state where they become failure focused.

Psychological ED – Failure focus.

Usually the result of the experience of not getting a sufficient erection failure focus maintains the problem. Typically, the guy’s attention around sex moves from focused upon how badly he wants to do X, Y or Z act, or how ‘hot’ his partner is, to focusing on his own sexual response. This manifests as doubt thoughts, like “will I get hard?” “will I stay up?” Sometimes it will manifest as fear of mockery “Will she laugh at me if I don’t get hard enough?” There is usually an implied disaster element to these thoughts, i.e. “if I don’t get hard it will be awful”, “if it doesn’t stay up then I’ll feel a failure as a man” All of which creates anxiety which inhibits sexual response.

Psychological ED is usually highly responsive to treatment. You may be interested in my blogs on treating ED and 7 psychological causes of ED